Prediction of outcome by computer-assisted analysis of lung area on
the chest radiograph of infants with congenital diaphragmatic hernia

Author(s)

Dimitriou G, Greenough A, Davenport M, Nicolaides K

Source

J Pediatr Surg, Vol. 35, No. 3, Pages 489-493

Publication Date

March 2000

Abstract

BACKGROUND/PURPOSE: Pulmonary hypoplasia is a major cause of mortality and
morbidity in infants with congenital diaphragmatic hernia (CDH). Pulmonary hypoplasia is
characterized by low volume lungs, and affected infants are likely to have a low lung area
on their chest radiograph. The authors assessed whether, in CDH infants, computer-assisted
analysis of the chest radiograph lung area gave an accurate indication of lung volume, and if
a low lung area was a better predictor of poor outcome (death or oxygen dependency at 28
days) than other test results. METHODS: Comparisons were made of the radiographic lung
area derived by computer-assisted analysis and lung volume, assessed by measurement of
functional residual capacity (FRC) on day 1 before surgical intervention and on the first
postoperative day. Compliance was measured, and the maximum and modified ventilation
indices and maximum Paco2 also was noted. Twenty-five CDH infants with a median
gestational age of 38 weeks were studied; 18 had FRC measurements preoperatively.
RESULTS: Both preoperatively and postoperatively, the lung areas and FRCs correlated
significantly (r = 0.51, P